Machine for external cardiac massage



March 22, 1966 TAMBASCIA 3,241,551

MACHINE FOR EXTERNAL CARDIAC MASSAGE Filed Sept. 13, 1961 2 Sheets-Sheet1 IN VEN TOR.

ATTORNEYS.

March 22, 1966 J. J. TAMBASCIA MACHINE FOR EXTERNAL CARDIAC MASSAGE 2Sheets-Sheet 2 Filed Sept. 13, 1961 INVENTOH; Join J ZamfiamamATTORNEY-S.

United States Patent M 3,241,551 MACHINE FOR EXTERNAL CARDIAC MASSAGEJohn Joseph Tambascia, Bloomfield, N.J., assignor to Medi TechLaboratories, Summit, N.J., a corporation of New Jersey Filed Sept. 13,1961, Ser. No. 137,904 11 Claims. (Cl. 128-51) This invention relates toa machine for external cardiac massage, a resuscitative technique whichhas recently come to the fore. Open-chest cardiac massage has been usedfor quite some time for the management of sudden cardiac arrest. Theclosed-chest technique was resorted to because tho racotomy is aformidable procedure which must be carried out in an operating roomunder the most opportune circumstances and which frequently results intrauma, blood loss, shock and infection.

Closed-chest cardiac massage consists of the rhythmic application ofmanual pressure to the lower third of the sternum with simultaneousventilation of the lungs, either mouth to mouth or mouth to nose, begunshortly after cardiac arrest. Depression of the sternum from 1 /2 to 2inches compresses the heart and forces blood into the pulmonary andsystemic arteries. When pressure is released, the chest expands and theheart fills with oxygenated blood, which is circulated to the tissues.The cycle is repeated about 60 to 80 times per minute. The results havebeen favorable.

Although closed-chest cardiac massage overcomes the common sequelae ofemergency thoracotomy as noted above, it is not without complications,such as rib fractures, liver injury, marrow emboli, hemothorax andhemopericardium.

The primary object of the invention is to provide an external cardiacmassage device which minimizes the complications of the manual techniquenoted above. This is accomplished by incorporating means therein for theapplication of a proper amount of depression only to the lower third ofthe sternum.

Another object of the invention is to provide an external cardiacmachine which, because of the mechanical advantage it enjoys, lessensthe strain on the operator and thereby permits more efficientapplication of repetitive compressive force to the sternum.

Another object of the invention is to provide an external cardiacmachine which obviates the need to place the patient on a hard surfaceas it employs an adjustable means to engage the back between thevertebra opposite the sternum and thereby provide a pressure point tolocalize the compressive action on the lower ventricle of the heart.

Yet another object is to provide a machine of the character describedwhich is relatively inexpensive, easy to operate, light and portable sothat the same can be used at bedside, in an ambulance, at the seashoreand other places where cardiac arrest has occurred.

These and other objects will become more apparent as the followingdescription proceeds in conjunction with the accompanying drawings,wherein:

FIGURE 1 is a perspective view of the invention;

FIGURE 2 is a sectional view taken on the line 2-2 of FIGURE 1;

FIGURE 3 is a diagrammatic view illustrating the compressive action; and

FIGURE 4 is a fragmentary perspective view of a modified form of theinvention.

Specific reference is now made to the drawings in which similarreference characters are used for corresponding elements throughout.

The machine is indicated at 19 and comprises an elongated base 12 to oneend of which is secured a pedestal 14 carrying a pair of uprights 16,the upper ends 3,241,551 Patented Mar. 22, 1966 of which are providedwith a carrying handle 17. The base includes an elongated groove withinwardly sloping sides 18 which extends the length of the base and opensthrough the pedestal. Mounted for sliding movement in the groove is abar 24 whose side edges are sloped complementarily to the sides 18 ofthe groove to restrain upward movement of the bar relative to the base.The upper face of the bar is flush with that of the base and mounted onsaid upper face of the bar is a fixation block or protuberance 22 whichis preferably semi-circular in form as shown.

A member 24 is provided which consists of a pair of clamping blocks 26and 28 with complementary vertical grooves receiving the uprights orposts 16. Threaded bolts 30 extend through the plates adjacent the postsand receive wing nuts 32 by which the member 24 may be releasablyretained in an adjusted fixed position vertically of the posts.

The member 24 is provided with a transverse or through bore 34 whichslidably receives an arm 36 whose crosssectional dimension is somewhatless than that of the bore. To fixedly adjust the position of the arm inthe member 24, a pressure plate 38 is retained in the bore against thearm, the same having a screw or threaded bolt 40 which extendsvertically through the member 24 and receives a thumb nut 42 to tightenor loosen the gripping pressure of the plate on the arm.

The arm 36 is enlarged at one of its ends as at 44 and mounts thereatfor reciprocating vertical movement a sternum compressor. Extendingvertically through the arm is a toothed rack 46 to the lower end ofwhich is secured, preferably removably as by a set or Allen screw (notshown), a collar 48. Glued or otherwise secured to the collar is arubber compressor disk 50 whose diameter approximates /a the overalllength of the sternum. Journaled transversely in the arm is a stub shaft52 to one external end of which is secured a collar 54 carrying anoperating arm 56. Intermediate its ends, the stub shaft mounts a pinionor gear 58 which is disposed in a cavity 60 in the enlarged end of thearm and is in engagement with the teeth of the rack 46. A coil spring 62is wound about the shaft to one side of the pinion which is terminallysecured to the arm and the shaft as at 64 and 66. Thus when the arm 56is rotated downwardly, the rack also moves downwardly winding up thespring which therefore normally urges the rack and compressor upwardlyaway from the base.

To adjustably limit the downward stroke of the compressor to avoidcompressing the sternum of a given patient beyond 1 /2 to 2", a plate 68is secured to the rack 46 adjacent the compressor, the plate extendingbeyond the side face of the arm 36. At said end the plate 68 fixedlymounts as at 70 a vertical threaded shaft 72 which extends looselythrough the yoke end 74 of a further plate 76 which is secured to theenlarged end 44 of the arm 36. Movably threaded on the shaft is a nut 78which is adapted to be positioned at a selected one of the scalemarkings 80 along the length of the shaft, the markings representing thelimitation of the compressor stroke required for the infant, child,adolescent and adult.

The modification shown in FIGURE 4 differs from that described abovesolely in the fact that the slide bar 20 is provided with a scale 82which is to be indexed against the rear edge of the pedestal 14 andanother scale 84 on the arm 36 correlative with scale 82 and also to beindexed against the rear edge of the clamping member 24.

In use, the patient (shown diagrammatically as 86 in FIGURE 3) is laidacross the base with one side against the pedestal 14 and the slide bar20 is moved until the fixation block or protuberance 22 is positioned inthe 1ongitudinal groove 88 of the back along the vertebral column 90 anduntil the block 22 is positioned between the pair of vertebra directlyopposite the sternum. The clamping block 24 is then adjusted to adesired height by the nuts 32 and the arm 36 is similarly adjusted bythe nut 42. so that the compressor will engage the lower third of thesternum in opposition to the fixation block 22. To assist in thisadjustment the arm 36 may be moved to the marking or its scale 84 whichcorresponds to that on scale 82. Then the nut 78 is moved on the shaft72 to the desired scale marking 80 and the operating handle 56 rotatedto lower the compressor against the sternum. The action, as shown inFIGURE 3, compresses the left ventricle of the heart 92 because, inarrest, the heart is considerably enlarged. This action is greatlyenhanced by the fact that the fixation block presses against the backdirectly behind the lower third of the sternum and thereby acts as acounter-pressure point. To avoid injury to the ribs or liver, thedownward stroke should be limited so that the sternum is compressed nomore than 1%. to 2". The adjustment nut 78 is effective for this purposeas it strikes the plate 74 and prevents further downward movement of thecompressor beyond the stroke required for the particular patient. Ofcourse, the device may be used in conjunction with a defibrillator whenrequired.

While preferred embodiments of the invention have here been shown anddescribed, minor variations may be made by skilled artisans withoutdeparting from the spirit of the invention and the scope of the appendedclaims.

I claim:

1. An external heart massage device comprising an elongated base and anupright member secured thereto, means mounted on said base forlongitudinal adjustable movement thereof and including a protuberanceadapted to engage the back of a person at a point opposite the sternum,an elongated arm, means mounting said arm on said upright for verticaladjustable movement thereof, means for adjusting said arm longitudinallyof said base, a sternum compressor and means mounting said compressor onsaid arm for reciprocating vertical movement towards and away from saidbase.

2. The device of claim 1 and adjustable means limiting the downwardstroke of said compressor.

3. The device of claim 1 wherein said first-named means includes anopen-ended groove in said base and a bar slidable in said groove, saidprotuberance being carried by said bar and extending above said base.

4. The device of claim 3 and correlated scales on said arm and slide barwhereby adjustment of said arm and slide bar may be readily effected sothat the compressor is directly opposite the protuberance.

5. The device of claim 1 wherein said compressor mounting means includesa rack bar slidable vertically through said arm, said compressor beingsecured to the lower end of said rack bar, a pinion rotatably mounted onsaid arm engaging said rack bar, and resilient means urging said rackbar upwardly.

6. The device of claim 5 and adjustable means limiting the downwardstroke of said compressor, said limiting means including a verticallyextending member carried by said rack bar and a stop on said memberadjustable along its length and adapted to abut a portion of said arm onthe downstroke.

7. The device of claim 1 wherein said means mounting said arm on saidupright for vertical adjustable movement includes a member including asplit clamp embracing said upright and means to releasably close saidclamp on said upright in a selected position.

8. The device of claim 7 wherein said means for adjusting said armlongitudinally of said base includes a bore transversely through saidclamp member loosely receiving said arm, a pressure plate in said boreagainst said arm and releasable means to press said plate against saidarm and retain it in a fixed selected position.

9. In an external heart massage device including a base mounting an armabove the base for adjustment lengthwise thereof, and a verticallyreciprocal sternum compressor carried by said arm, a protuberanceadapted to engage the back of a person between vertebra opposite thesternum and means mounting said protuberance on said base for adjustmentalong the length thereof.

10. The device of claim 3 and adjustable means limiting the downwardstroke of said compressor.

11. An external heart massage device comprising a base, an elongatedarm, means mounting said arm above said base for adjustment verticallytowards and away from said base, a sternum compressor carried by saidarm, means to reciprocate said sternum compressor vertically, adjustablemeans limiting the downward stroke of said sternum compressor, and aprotuberance on said base vertically opposite said sternum compressorand adapted to engage the back of a person opposite the sternum.

References Cited by the Examiner UNITED STATES PATENTS 1,918,546 7/1933Johnson 128-28 FOREIGN PATENTS 33,302 6/1908 Austria. 673,551 3/1939Germany.

OTHER REFERENCES Boehm, R.: V. Arbeiten aus dem pharmakologischenInstitute der Universitat Dorpat: 13. Ueber Weiderbelebung nachVergiftungen und asphyxite, Arch. exper. Path u. Pharmakokol 8: 69l0l,1878.

Kouwenhoven, W. B., Jude, I. R.. Knickerbocker, G. G.: Closed ChestCardiac Massage, J.A.M.A. 173, 106401067, July 9, 1960.

RICHARD A. GAUDET, Primary Examiner.

R. J. HOFFMAN, Examiner.

1. AN EXTERNAL HEART MESSAGE DEVICE COMPRISING AN ELONGATED BASE AND ANUPRIGHT MEMBER SECURED THERETO, MEANS MOUNTED ON SAID BASE FORLONGITUDINAL ADJUSTABLE MOVEMENT THEREOF AND INCLUDING A PROTUBERANCEADAPTED TO ENGAGE THE BACK OF A PERSON AT A POINT OPPOSITE THE STERNUM,AN ELONGATED ARM, MEANS MOUNTING SAID ARM ON SAID UPRIGHT FOR VERTICALADJUSTABLE MOVEMENT THEREOF, MEANS FOR ADJUSTING SAID ARM LONGITUDINALLYOF SAID BASE, A STERNUM COMPRESSOR AND MEANS MOUNTING SAID COMPRESSOR ONSAID ARM FOR RECIPROCATING VERTICAL MOVEMENT TOWARDS AND AWAY FROM SAIDBASE.